Gluten-free diet could be damaging to health, warns expert

A gluten-free diet in the absence of diagnosed coeliac disease could result in a range of health problems including diabetes, obesity and malnutrition, according to a US-based gastroenterologist.

The gluten-free diet - that which excludes all food products derived from wheat, barley and rye grains including staple foods such as pasta, cakes and bread - has become increasingly popular in recent years. A 2015 YouGov poll found that 60% of UK adults had purchased gluten-free foods and one in ten households had at least one family member that believes they are intolerant to gluten. But in the absence of symptoms of coeliac disease – an incurable auto-immune condition characterised by bloating, abdominal pain, diarrhoea or constipation, nausea, fatigue, mouth ulcers, skin rashes and anaemia – are there any health benefits from going gluten-free?

A gluten-free diet in those who are not diagnosed coeliac could actually be harmful, according to a renowned gastroenterologist. Writing in the Journal of Pediatrics, Dr Norelle Reilly of New York’s Columbia University Medical Center says that while a gluten-free diet may be beneficial for those diagnosed with coeliac disease, following a gluten-free diet offers no benefits to healthy people and may actually be harmful to health.

Dr Reilly warns: “There is no evidence that processed gluten-free foods are healthier nor have there been proven health or nutritional benefits of a gluten-free diet. There are no data to support the theory of intrinsically toxic properties of gluten in otherwise healthy adults and children.

“Gluten-free packaged foods frequently contain a greater density of fat and sugar than their gluten-containing counterparts. Obesity, overweight and new-onset insulin resistance and metabolic syndrome have been identified after initiation of a gluten-free diet. It may also lead to deficiencies in B vitamins, folate and iron, given a lack of nutrient fortification of many gluten-free products.”

How common is coeliac disease?

According to Coeliac UK, coeliac disease is relatively common, affecting 1 in 100 people in the UK. This risk increases to 1 in 10 if you have a close family member who has the disease, however, the charity says that only 24% of sufferers have an official diagnosis. Prior to excluding gluten, Coeliac UK suggests discussing any concerns with your GP who may refer you for tests before a diagnosis can be made. For more on diagnosis, visit Coeliac UK.

Industry niche worth billions

Once available via prescription only, gluten-free foods are now widely available from all major supermarkets, many of which now have a dedicated range of products. While the prevalence of coeliac disease is said to be increasing, the food industry niche has expanded disproportionately in recent years, with a reported growth globally of 136% between 2013 and 2015. This increase, say some experts, may indicate that gluten-free products are being consumed by individuals who are choosing to adopt a lifestyle as opposed to excluding gluten out of necessity. According to the Food Standards Agency, the UK gluten-free market was last estimated to be worth £238 million a year, and is forecast to grow to £561 million by 2017.

Gluten-free products “prohibitively expensive” for some

With increasing financial pressures, many NHS Clinical Commissioning Groups are now restricting or withdrawing prescriptions for gluten-free foods for patients with diagnosed coeliac disease, on the premise that gluten-free products are now more widely available. This has led to a campaign from Coeliac UK, who say that the elderly and those living in rural areas often still struggle to obtain gluten-free foods. With a price tag that is three to four times costlier than their standard alternatives, Coeliac UK says gluten-free products are also “prohibitively expensive” in the longer term for those on a limited income.

Dr Reilly adds: “The gluten free diet should be recommended judiciously and patients self-prescribing a gluten free diet should be counselled as to the possible financial, social and nutritional consequences of unnecessary implementation.”

Dr Naveed Sattar, Professor of metabolic medicine at the University of Glasgow says: "This is a well thought out point of view and I agree with the points made - people should not adopt a gluten-free diet on the basis that they think it will be beneficial to their health unless they have a diagnosis of a condition such as coeliac disease."

Extolling the virtues

The gluten-free diet trend may have been boosted by numerous celebrities who reportedly extol the virtues of such a diet, including the svelte Victoria Beckham, Gwyneth Paltrow and Miley Cyrus, who purportedly stay slim, fit and healthy while following a gluten-free diet.

According to Food Engineering magazine, Europe is the largest regional market for gluten-free products, where market researchers found that some consumers believe obesity to be a symptom of gluten intolerance, further reinforcing the perception that following a gluten-free diet may aid weight loss.

For more information on coeliac disease and to take an online assessment if you believe you may have the disease, visit Coeliac UK.